Tools and Decision Making for Ongoing Performance Management - Case Study Example

Tools and Decision Making for Ongoing Performance Management Presentation Student inserts His/Her Name Here Lecturer Inserts Student 22nd January, 2011. Outline Introduction Organizational Review Organizational Medical Standards and Requirements Information, decision making and Risk Management Challenges of decision making in Risk Management Conclusion Table and questions Introduction Healthcare management is very important, since our health and well being is vital in the day to day life of any person. Healthcare organizations are mainly responsible for welfare of its patients/customers, staff and the community/environment in an effective and responsible manner. For effective management of healthcare organizations several strategies must be implemented, these strategies should be in line with best practices of performance management. Organizational performance management deals with effective implementation and delivery of quality health care to patients in need. Healthcare organizations are operated by professionals who are skilled in various disciplines; these professionals usually rely on decisions to implement the objectives and goals of their organizations (McLaughlin, 2006). In this research paper we are going to focus on one organization based in Minnesota known as Field Crest Care Center. This organization was established in 1969 to provide care for the aged people in the community, the center boasts of excellent facilities such as dietary, nursing, laundry, housekeeping and social services. The Center is owned by the municipal council of Hayfield in Minnesota. The report will focus on regulations, accreditation requirements, performance standards and processes which are important in implementation of performance management. Organizational Review The management of a healthcare institution like Field Crest Care Center requires prudent management in accordance with set medical standards of licensure and operation. Field Crest Care Center is a municipally owned non-profit organization that provides care for the aged in the society. The facility employees 80 people who work in different departments such as laundry, dietary, nursing, housekeeping, maintenance, administration, social services, and recreational activities. The institution has affiliations with the Aging Services of Minnesota and the American Association of Homes and Services for the Aging. Managing an institution like Field Crest Care Center presents many challenges in which most of these challenges have to do with offering quality healthcare (McLaughlin, 2006). Through the practice of prudent management skills, management can make important decisions and undertake these decisions in offering quality healthcare. Field Crest Care Center being a publicly funded organization faces quite a number of challenges including financial constraints, knowledge management and implementation of decisions. For successful delivery of organizational goals at healthcare facilities such as Field Crest, exposure to risks must be addressed and reduced. The American Society of Healthcare Risk Management has defined various methods of identifying and solving risks associated with running hospitals (Carroll, 2009). Organizational Medical Standards and Requirements In the United States, healthcare facilities are licensed by the Department of Health and Human Services using regulatory guidelines provided by the Centers for Medicare & Medicaid Services (CMS). Field Crest Care Center being located in Minnesota must adhere to regulations in its operations as guided by the Minnesota Department of Health. Non-compliance to regulations and procedures set by the Minnesota Department of Health and CMS usually leads to severe punishments such as closure of the institution. Sometimes conflict arises as it concerns the implementation of regulations laid down by licensing bodies since some regulations of the CMS conflict with Minnesota Department of Health and thus creating a quagmire for the institutions (Swayne, 2006). For instance Chapter 144A of the Minnesota statutes is used in regulating healthcare facilities in the State, in section 61 of the Minnesota law defines a nursing assistant role which could be different from roles set out in the Public Law adopted by the all the 51 States in USA. Healthcare facilities like Field Crest Care Center participate in providing care for patient and therefore they have to be very careful in managing risks that could affect their patients. Risks within a health facility include; injuries to patient, financial losses or non-compliance of regulatory policies (Carroll, 2009). In the provision of healthcare at a long term health facility special focus should be given to activities such as patient restraint, training offered to medical staff and other provisions related to National Patient Safety Goals. For instance, some scenarios are not tolerated by licensing and regulatory bodies like the Minnesota Department of Health. The Field Crest Care Center has adhered to these regulations; Federal Regulations for Long Term Care facilities, State licensing rules for Nursing Homes and State statutes for Vulnerable Adult Act. These provisions of the law go hand in hand with the Nursing Department Safety Rules, the laws are used to regulate activities at hospitals/Care centers and ensure that patient rights are protected. In case a medical practitioner is found to have contravened any of the regulations he/she may be fined or deregistered thus it is important to effectively ratify and create awareness of the laws to staff members. Information, decision making and Risk Management Healthcare institutions and its management rely on information from many sources in implementations of their agendas through decision making. For prudent decisions to be made, information has to be sought using effective methods in an organized and efficient manner. Some of the methods used in information gathering include; brainstorming sessions, conducting surveys, opinion polls and making use of knowledge repositories. In the process of gathering information, there is need to decipher these information into important processes or decisions to be used in running healthcare facilities. Field Crest Care Center could make use of information through use of knowledge management to come up with decisions to be used in running the institution (Burtonshaw-Gunn, 2010). Data collected from patients, other care providers and specialists could be processed into information used in drawing up explicit knowledge which is easily expressed though written or language systems. Explicit knowledge is easily understood because it is made up of published materials such as manuals or regulations, routines and procedures. Explicit knowledge’s major advantage is that they remain within the organization even in cases where the organization has a high staff turnover (Kavaler, 2003). Through use of methods such as PDCA (Plan, Do, Check and Act), Field Crest Center could plan on risk management by identifying potential risks within their facilities. Healthcare facilities do face potential risks such as best practices are maintained in hiring of staff such as nurses, nurses to be hired should be certified by the relevant governmental bodies (McLaughlin, 2006). Safety mechanisms should be put in place to reduce risk occurrence, some of the safety measures that could be implemented include use emergency response teams to take of risks exposure on patients. Field Crest Care Center has implemented risk management in accordance with Joint Commission on Accreditation of Healthcare Organizations (JCAHO) which requires the Standard Performance Improvement (PI) 3.9 be implemented for accreditation of a healthcare institution (Swayne, 2006). According to Gray (2006), the use of techniques like ‘failure mode effect analysis’ to look into effects of each failure mode on the patients and possible assessment on how to redesign the processes or activities that lead to failure mode. Other techniques that could be used in decision making include making use of Pareto charts, surveys to improve internal management of the health institution. Challenges of decision making in Risk Management Challenges in decision making arise from lack of proper mechanisms of analyzing data sourced from different sources and implementing results of different decisions made on management of the institution. Various management practices inculcate the use of knowledge management, operational management strategies that are useful in managing these institutions. Several challenges tough exist in the implementation of organizational goals. The use and implementation of knowledge management is one very important skill that is difficult for people to implement in managing issues that deal with risk and operational management (Carroll, 2009). Risks can cause a huge loss to a healthcare institution. For instance a scenario where a care provider (doctor) exercises negligence in undertaking his/her work could lead to lawsuits or even cause insurance claims against the institution. Knowledge management inculcates the use of data and information available or sourced elsewhere to put in place in inventing trends and strategies to be used in achieving improvement in organizational performance. Information and its use in managing risk is very important, recently most healthcare institutions have implemented technological means of computers in processing information and financial transactions. However this has created a problem of safety as some information which is deemed to be sensitive should not be disclosed to outsiders (Kavaler, 2003). This risk of sensitive information being put into use by unauthorized persons has led to organizations coming up with policies meant to thwart this risk. The recent enactment of HIPAA regulations which makes it a must for institutions to share sensitive information with governmental regulatory, licensing and accreditation bodies poses a major challenge to managing risk at an organizational level. The challenge of knowledge management in managing risk is the fact that trends in the healthcare industry are changing very often and therefore knowledge repositories and explicit knowledge could become obsolete very quickly presenting a huge challenge in the case of when new scenarios/problems occur (Gray, 2009). Conclusion In the achievement of organizational goals and objectives, various procedures related to performance and risk management are practiced by several healthcare institutions. Field Crest Care Center is a healthcare institution which has used various decision making mechanisms to manage risk and improve operational efficiencies. Regulations and accreditation standards are set by governmental bodies to ensure that risks are reduced and operational management is improved at all healthcare institutions (Burtonshaw-Gunn, 2010). Institutions such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) play a vital role in ensuring that patient rights, training and education is provided to employees and as a result organizational management is improved (Gray, 2009). The two most important aspects of management of healthcare institutions are operational management and risk management; if these two factors are effectively managed then an organization can be able to achieve its goals and objectives. Tools and Decision Making for Ongoing Performance Management Scenario Worksheet Using selected organization; this worksheet will provide the foundation for completing the Tools and Decision Making for Ongoing Performance Management Presentation. Scenarios: ABC organization has noticed an increase in patients who have acquired infections while receiving care and service. In fact, there seems to be so many different types of infections that the organization does not know where to start. With your guidance, the organization will be able to identify the types or categories of infections and the number of infections per category throughout the facility so they may determine the vital few and focus their efforts on the few areas that will bring about the greatest return on investment of time and effort. The organization needs to identify which infections affect the most patients. Which tools would you use to make this decision? Information: 1. What kind of information do you need to respond to this scenario? The kind of information needed to respond to this scenario is first hand information on the number of patient, their medical condition and category of infections to each patient. The information should 2. How and where can you acquire this information? This information can be acquired from employees at the hospital and from patients who have undergone the experience of suffering from the different types of aliments at the hospital. Information in such as a scenario should be gathered from the affected parties. 3. What processes should you use to gather this information? In this given scenario, the appropriate methods of gathering information would include Complete the following table: What kind of information will each tool provide? Under what conditions is this tool most applicable? FMEA This tool provides information on processes that have failed in its implementation at a given institution during the occurrence of a given situation/scenario. This tool would be appropriate for refining approaches to managing institutions/processes as opposed to the old processes which failed. Flow chart This is a tool used to draw and explain flow of information or processes within an organization. Flowcharts mainly focus on processes and result of the each process being undertaken to solve a certain situation/scenario. Flowcharts are mostly used in analyzing processes and are appropriate for expected (fixed) problems which could be solved used laid down procedures. Cause–and-effect diagram This tool is used in providing people’s ideas on problems causes and it usually provides organized ideas on approaching problems. This tool is very appropriate in investigating, ranking problems and ideas of tackling the problem. Used by a team of people. Check sheet This tool is prepared in a structured format and when used it avails structured data on frequency, patterns of problems/scenarios. This tool is appropriate for collecting data on problems associated with processing/processes. Useful in dealing with observations or real time events/problems. Control chart This tool is used in analyzing processes as they change over time. It usually avails data such as expected outcomes of processes, variation of a process from a common cause of a problem and stability of certain processes. They are appropriate in predicting problems that are likely to occur, solution of problems as they occur. Also used in determining fundamental changes to processes. Histogram This tool is used in measuring the frequency of distribution of data within a certain scenario/problem. This tool is appropriate for concluding processes which meet the customer satisfaction. Also used in analyzing outputs of similar processes, it works with numerical data. Pareto chart This tool provides information concerning significant problems in a process. It usually avails cost analyses in terms of frequency and money. Used in the analysis of frequency of problems in a process. Also used in analyzing significant problems within a process. Run chart This tool provides data on measure of performance over time of a specific process. Used in analyzing time average performances measures of a process/Problem within a scenario. Scatter diagram This tool provides information on correlation between two set of numerical data. It displays correlation results. Used in concluding potential causes of a problem. Also used in concluding whether two factors which appear to be related occur similarly or at the same rate. How do you determine which tool is most appropriate? In determining the best tool to be used, we shall examine the factors such as accuracy, effectiveness and cost. An appropriate tool should give the best results within a short period of time, is fault tolerant and can be easily used at a cost friendly price. What are the most appropriate tools for responding to this scenario? The best tools in responding to this scenario include: FMEA, Cause and effect diagram, Control chart and histogram. Response: 4. How will you respond to the scenario? Explain your reasoning. The appropriate method of responding to this scenario is to make analysis on methods of how to manage risks to the hospital and the patients. The only method of managing risk in this scenario is to avail treatment to patients who suffer most from an infection in one of the categories. Through this method we reduce exposure of risk to many patients who cause financial loss to the hospital through fling of law suits against the hospital. Collaboration: 5. How did your team come to an agreement about this scenario? Our team decided to act on the infection cases which had the highest frequencies in their category and by controlling the infections within these categories. We decided to form a risk management team to look into the infection issues and take the shortest time possible in availing medical care to all infected patients and placing infected under quarantine to avoid further spread of the infection to other patients. 6. What challenges did you encounter? How did you overcome these challenges? Challenges we faced in this scenario was analyzing the patients who suffered the most during the infection, decision making and implementing risk management policies set down. These challenges were overcame by dividing staff into small teams thus decision making became faster and response time increased as the teams were assigned to specific cases in this scenario. References Burtonshaw-Gunn, S. (2010). Essential Tools for Operations Management: Tools, Models and Approaches for Managers and Consultants. Atlanta, GA: John Wiley and Sons. Carroll, R. L. (2009). Risk Management Handbook for Health Care Organizations. Boston, MA: John Wiley & Sons, Inc. Gray, J. A. (2009). Evidence-based healthcare and public health: how to make decisions about health services and public health. Los Angles, CA: Elsevier Health Sciences. Kavaler, F., & Spiegel, A. D. (2003). Risk management in health care institutions: a strategic approach. New York, NY: Jones & Bartlett Learning. McLaughlin, C., & Kaluzny, A. (2006). Continuous Quality Improvement in Health Care: Theory, Implementations, and Applications. Sudbury, MA: Jones and Bartlett Publishers. Swayne, L., Duncan, J., & Ginter, P. (2006). Strategic management of health care organizations. Birmingham, AL: Wiley-Blackwell. Read More